Korean J Nephrol.  1999 Nov;18(6):922-933.

A Changes of Electrolytes and Biochemical Components during Hemodialysis

• Kim W
• Kang SK
• Lee BC

Abstract

To investigate the changes of electrolytes and bio-chemical components during hemodialysis in 15 patients(7 men and 8 women) with end-stage renal disease undergoing long-term hemodialysis were studied. The mean age of 15 patients undergoing long-term hemodialysis was 45 year(range ; 26-62). The mean duration of hemodialysis was 58 months(range: 19-143) at time of the study. Hemodialysis was performed with acetate dialy- sate having 37mEq/1 acetate and 8.57g/100ml glu-cose(group A), with bicarbonate dialysate having 8 mEq/1 acetate and 30mEq/1 bicarbonate without glu-cose(group B) for 4-hour. Each blood sample was drawn for blood gas analysis, blood glucose, blood urea nitrogen and electrolytes from the arterial line at 0, 1, 2, 3, and 4-four during hemodialysis. In group A, the body temperature measured at 1 hour increased significantly compared with that of predialysis. The blood glucose level increased pro-gressively during dialysis. In group B, the body temperature measured at 1 hour also increased sig- nificantly compared with that of predialysis. However, the blood glucose level increased progressively during dialysis as removing urea in blood during dialysis. These results suggested that blood urea nitrogen may be a cause of hypothermia. Mean corpuscular volume(MCV) increased significantly at 2-hour in group A and returned to baseline values at 4-hour. In group B, the mean level of glucose value in dialysate of outlet line of dialyzer increased to 38.3mg/dl from zero in inlet line, and PaC&z decreased significantly because of diffusion of COz across the dialyzer. In Group A, PaOz decreased significantly at 1-hour and returned to baseline values at 4-hour, whereas HCC4 was increased significantly at 4-hour. The intracellular potassium content may decreased in long-term hemodialysis patients cornpared with normal control. In Group A, hernoglobin diphosphoglycerate(2, 3-DPG) concentraion increased from 10.9 pmoVg before dialysis to 19.9pmol/g after dialysis. Despite substantial anemia, hemoglobin 2, 3-DPG prior to dialysis was significantly lower than the value obtained in the normal control(17.5+4.3 p moVg). In group A, the blood lactate level decreased significantly at 1-hour and returned to baseline values at 4-hour. Our data suggested that body temperature might be increased due to removal of urea nitrogen, and blood glucose may be decreased because of the dif- fusion across dialyzer. In addition, this study showed that intracellular potassium content was lowered, the MCV of RBC was increased during hemodialysis. Transient decrement of PaCOz during early phase of dialysis and decreased hemoglobin 2, 3-DPG of despite anemia before dialysis improved with the increment of blood pH and HCC4 at the end of dialysis.

MeSH Terms

Anemia
Bays
Blood Gas Analysis
Blood Glucose
Blood Urea Nitrogen
Body Temperature
Dialysis
Diffusion
Electrolytes*
Glucose
Humans
Hydrogen-Ion Concentration
Hypothermia
Kidney Failure, Chronic
Lactic Acid
Male
Nitrogen
Potassium
Renal Dialysis*
Urea
Vascular Access Devices
Blood Glucose
Electrolytes
Glucose
Lactic Acid
Nitrogen
Potassium
Urea